Are there reliable tests for lactose / gluten intolerance

Hello, DS2 (5 years old) almost daily complains of stomach aches. He is pasty faced often and has a bout of constipation every couple of months. We've long wondered if there is something dietary going on. He's been allergy tested and nothing came up except a dust allergy. He also saw a gastroenterologist but because the symptoms were a bit vague he didn't really say much except to keep up the fruit etc to avoid constipation.

I saw Lactofree milk at the supermarket the other day and thought I'd give it a try. He's had it the past couple of days for morning / evening milk and on his cereal and it may be a coincidence but he hasn't had a bad stomach. I wonder about gluten also but have never tried cutting it out.

I don't want to self diagnose and want to look into this properly but not too sure how to proceed. I'm very wary of intolerance testing places that might show up all kinds of spurious results.

What's the most reliable way to find out if he actually may have an intolerance? Is it an elimination diet or is there a reliable test/tests I can get done?

There is a blood test for coeliac disease which your GP can request, but when my DD needed one the GP was very cautious as it required quite a large sample and he was worried she would be distressed.However the blood test isn't 100% definite, my DSis needed a biopsy of her gut lining for the diagnosis to be confirmed.

I imagine if he was coeliac he'd be more unwell? (he's tall for his age, well built, generally very active). Though if it's a possibility I'd want to get it checked out. More thinking about intolerance, to the extent that can be defined as a medical thing, which is what I'm not sure about.

My DD (5) was diagnosed with Coeliac disease last summer, very healthy child but same issue with almost daily stomach aches. I just asked her doctor to order the blood test and then went from there (gastroscopy and biopsy are the gold standard for diagnosis but I have heard that sometimes they don't do the gastroscopy on young children if the blood levels are high enough)

Saw a paediatrician today - going to get coeliac tested but he says v unlikely. He told me there is no reliable test for lactose intolerance and the only thing we could try was cutting it out of the diet for a while. Is that right? Anyone know of a lactose intolerance test?

Definitely no test for lactose intolerance. And definitely don't cut out gluten before doing that test, as having a diagnosis is important is he is coeliac.

If you're sure it's dairy related I think the main thing would be making sure it's the lactose rather than the casein (sp?) - if he's ok with lactofree it's definitely lactose though.

Basically, lactose intolerance effects people at different levels, so you may want to reduce his dairy rather than totally switch it out and see what level her is at. I know some people can have, say, a yoghurt a day but not a glass of milk as well. I can't consume any (regular) dairy in the form of milk, cream or yoghurt, I'm fine with butter (which has minimal lactose) and I'm mostly fine with shop-bought chocolate, whereas fancy chocolate makes me ill. Lactofree has been a godsend- they also do cream cheese, cream and a v rubbery but child-friendly cheddar as well as yoghurts. Holland and Barrett also do lactase tablets- the enzyme which your body doesn't produce if you're lactose intolerant. So if it is that, he could possibly get to the point where he could take one of those then have e.g. a slice of birthday cake for a special occasion.

Good luck finding it out-it's a horrible period where food causes you pain and you're not sure why, I imagine even more so for a child.

Thanks. We are doing blood tests this week or next as well as a stomach ultrasound - after that we'll push for the hydrogen test. Trying to avoid constipation also by giving small dose of Lactulose but that has lactose in so can't check for both at once.